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About one fourth of the world’s population is estimated to have been infected with the tuberculosis (TB) bacilli, and about 5–10% of those infected develop TB disease in their lifetime. The risk for TB disease after infection depends on several
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factors, the most important being the person’s immunological status. TB preventive treatment (TPT) given to people at highest risk of progressing from TB infection to disease remains a critical element to achieve the global targets of the End TB Strategy, as reiterated by the second UN High Level Meeting on TB in 2023. Delivering TPT effectively and safely necessitates a programmatic approach to implement a comprehensive package of interventions along a cascade of care: identifying individuals at highest risk, screening for TB and ruling out TB disease, testing for TB infection, and choosing the preventive treatment option that is best suited to an individual, managing adverse events, supporting medication adherence and monitoring programmatic performance
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This document, Ghana’s National Newborn Health Strategy and Action Plan 2014–2018 outlines a targeted strategy for accelerating the reduction of newborn deaths in Ghana. Furthermore it provides a costed action plan with clearly marked timelines
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for implementation to facilitate resource mobilisation, monitoring and evaluation, and scaling up of proposed newborn interventions. It is expected that all stakeholders working towards improving the health of children in Ghana will buy into this plan and collaborate towards attainment of the goals and objectives outlined here.
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In fragile, conflict-affected and vulnerable settings, delivery of quality health services faces significant challenges, including disruption of a routine health service organization and delivery systems, increased health needs, complex and unpredictable resourcing issues, and vulnerability to multi
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ple public health crises. Despite the difficulty of addressing quality in such settings, the necessity for action is acute, given the significant health needs of the populations in these environments and the increasing numbers of people for whom such settings are home.
This manual has been developed to provide a starting point for multi-actor efforts and actions to address quality of care in the most challenging settings. This includes practical approaches to action planning and implementation of a contextualised set of quality interventions.
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The Lancet Planetary Health Volume 5, ISSUE 7, e466-e478, July 01, 2021
Transmission of many infectious diseases depends on interactions between humans, animals, and the environment. Incorporating these complex processes in transmission dynamic models can help inform policy and disease control
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interventions. We identified 20 diseases involving environmentally persistent pathogens (ie, pathogens that survive for more than 48 h in the environment and can cause subsequent human infections), of which indirect transmission can occur from animals to humans via the environment.
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This handbook builds on lessons learned from surveys implemented 2015-2017 and advice provided by the Global task force on TB patient cost surveys. It provides a standardized methodology for conducting health facility-based cross-sectional surveys t
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o assess the direct and indirect costs incurred by TB patients and their households. In addition, it provides recommendations on results dissemination, engaging across sectors in policy dialogue and enabling action and related research for effective modifications in care delivery models, in patient support, and wider cross-sectoral interventions.
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Policy Research Working Paper 6100 | Impact Evaluation Series No. 60 | This study examines the effect of performance incentives for health care providers to provide more and higher quality care in Rwanda on child health outcomes. The authors find th
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at the incentives had a large and significant effect on the weight-for-age of children 0–11 months and on the height-for-age of children 24–49 months. They attribute this improvement to increases in the use and quality of prenatal and postnatal care. Consistent with theory, They find larger effects of incentives on services where monetary rewards and the marginal return to effort are higher. The also find that incentives reduced the gap between provider knowledge and practice of appropriate clinical procedures by 20 percent, implying a large gain in efficiency. Finally, they find evidence of a strong complementarity between performance incentives and provider skill .
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Suicides take a high toll. Over 800 000 people die by suicide every year and it is the second leading cause of
death in 15-29-year-olds. Most suicides occur in low- and middle-income countries where resources
and services, if they do exist, are often scarce and limited
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for early identification, treatment and support of
people in need. These striking facts and the lack of implemented timely interventions make suicide a serious
global public health problem that needs to be tackled urgently.
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Stenotrophomonas maltophiliais a nonfermenting Gram-negative rod that is ubiquitous in nature (predominantly occurring in aquatic environments and on plants). Biochemically, it iscatalase positive and oxidase negative, and it produces acid frommaltose (hence the name“maltophilia”). Due to it
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s chargedcell wall surface and biofilm production, it may attach to and survive on abiotic surfaces in clinical settings (eg, central venouscatheters, disinfectant and hand-washing solutions, solutions for hemodialysis, endoscopes, inspiration/expiration circuits of ventilators, nebulizers, tap water, and showerheads).
Health Services Research and Managerial Epidemiology Volume 6: 1-9ªThe Author(s) 2019
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Obesity in all age groups, including children and adolescents, is a public health challenge across all settings. Obesity is now classified as a complex multifactorial chronic disease and not just a risk factor for other noncommunicable diseases and
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comorbidities. Recognizing the significance of primary health care for an effective and efficient response to the obesity epidemic, the World Health Organization (WHO) has developed guidance on how to build capacity in the health system to deliver health services for prevention and management of obesity across the life course. This policy brief discusses the challenges and opportunities for preventing obesity in children and adolescents, and providing health services to treat and manage those already living with obesity. It outlines possible interventions through the primary health care approach.
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Severe cases of COVID-19 are associated with rehabilitation needs related to the consequences of ventilatory support, and prolonged immobilization and bed rest. These may include: − Impaired lung function; − Physical deconditioning and muscle weakness; − Delirium and other cognitive impairment
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s; − Impaired swallow and communication; and − Mental health disorders and psychosocial support needs. − Rehabilitation needs may be amplified by underlying health conditions and decrements in health associated with ageing, − Rehabilitation professionals play an important role in facilitating early discharge, which is especially critical in the context of hospital bed shortages. − Rehabilitation needs of people with severe COVID-19 exist during the acute, sub-acute and long-term phases of care; rehabilitation professionals should be positioned in ICUs, hospital wards, stepdown facilities and in the community. − Particularly in the acute phase, rehabilitation interventions for patients with severe COVID-19 requiring ventilatory support generally require a particular skill-set acquired through specialist training.
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The protracted humanitarian situation in northeastern Nigeria, particularly in Borno, Adamawa, and Yobe (BAY) States, remains a concern due to ongoing insecurity, displacement, food insecurity, disease outbreaks, and climate-related shocks. To address these complex challenges, the health sector has
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developed a comprehensive humanitarian response strategy aligned with the three States Development plans, Durable Solutions for the Population Displacement Plan, and the Humanitarian Need Response Plan for 2025. This strategy aims to reduce morbidity and mortality among crisisaffected populations by ensuring timely, equitable, and effective delivery of lifesaving health services, while strengthen the resilience of health system and enhancing local and national capacities for sustainable health response in protracted emergency.
Supported by an in-depth analysis of the ongoing health humanitarian response using the Strengths, Weaknesses, Opportunities, and Threats (SWOT) methodology, the strategy is guided by three key objectives:
1. Provide access to lifesaving interventions and sustain an effective response to the prolonged health emergency.
2. Prevent, mitigate, and prepare for health risks from all hazards and respond to all health emergencies.
3. Advance the primary health care approach and essential health system capacities for universal health coverage.
To achieve these objectives, the strategy employs the “Five C” framework which refers to:
• Collaborative Surveillance: Enhancing collaborative efforts for effective monitoring.
• Community Protection: Implementing community-based protection measures.
• Safe and Scalable Care: Ensuring care that is both secure and scalable.
• Access to Countermeasures: Facilitating access to necessary countermeasures.
• Emergency Coordination: Coordinating emergency responses efficiently.
These proactive approaches are designed to be more anticipatory and preemptive rather than reactive, aiming to meet the needs of the crisis-affected population by providing lifesaving interventions, enhancing preventive and anticipatory actions, and ensuring the resilience of the health system. All actions are guided by International Humanitarian Standards and the Humanitarian Principles.
The implementation of the health humanitarian response strategy will involve collaboration with local authorities, non-governmental organizations (NGOs), and international organizations. The strategy emphasizes localization and resource mobilization, efficient logistics and supply chain management, mainstreaming protection, and the deployment and training of healthcare workers. Continuous monitoring and periodic evaluation will ensure the effectiveness of the response. Cross-sector collaboration with sectors such as WASH, Nutrition, Education, and Protection will be crucial to enhance the quality and reach of health interventions. Additionally, sustainability and transition approaches will ensure long-term health outcomes and benefits, bridging the gap from humanitarian to development efforts.
By adopting this comprehensive approach, the humanitarian response in northeastern Nigeria, particularly in BAY States, can be effectively guided, ultimately reducing the suffering of affected populations.
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This toolkit is a comprehensive set of practical tools and resources designed to support country-level risk communication and community engagement (RCCE) practitioners, decision-makers and partners to plan and implement readiness and response activities fo
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r Ebola disease outbreaks. The toolkit contains: information about Ebola disease; RCCE considerations on how to approach key issues during Ebola disease outbreaks; tools for understanding the context in which Ebola disease outbreaks occur; methods for collecting data to inform strategy development and bring evidence into the planning and implementation of activities; guidance to support prevention and response interventions; and links to existing RCCE tools and training. It is one of a suite of toolkits on RCCE readiness and response to a range of disease and response areas.
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The World Health Organization recently redefined leprosy elimination as a phased process, with the first milestone being the
interruption of transmission, achieved when no new child cases (defined as younger than 15 years) are reported for five con
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secutive years.
In Pakistan, the well-functioning leprosy programme, with effective case management, context-specific active case-finding strategies and
a robust data management system, has contributed to a decrease in new cases. Between 2001 and 2023, new adult cases dropped by 75%
(from 878 cases to 220 cases annually) and child cases by 83% (from 93 to 16). To support the country’s goal of no new child cases by 2030
and ultimately eliminate the disease, the nongovernmental organizations Marie Adelaide Leprosy Centre and Aid to Leprosy Patients, with
support from the German Leprosy and Tuberculosis Relief Association, have developed a zero leprosy roadmap. As part of this roadmap,
the leprosy elimination strategy emphasizes improving active case-finding and providing post-exposure prophylaxis for contacts of leprosy
cases, who are at the highest risk
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Cancer in sub-Saharan Africa
recommended
Lancet Oncol 2022; 23: e251–312Published OnlineMay 9, 2022 https://doi.org/10.1016/S1470-2045(21)00720-8
In sub-Saharan Africa (SSA), urgent action is needed to curb a growing crisis in cancer incidence and mortality.
Without rapid interventions
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, data estimates show a major increase in cancer mortality from 520 348 in 2020 to about
1 million deaths per year by 2030. Here, we detail the state of cancer in SSA, recommend key actions on the basis of
analysis, and highlight case studies and successful models that can be emulated, adapted, or improved across the
region to reduce the growing cancer crises. Recommended actions begin with the need to develop or update national
cancer control plans in each country. Plans must include childhood cancer plans, managing comorbidities such as
HIV and malnutrition, a reliable and predictable supply of medication, and the provision of psychosocial, supportive,
and palliative care. Plans should also engage traditional, complementary, and alternative medical practices employed
by more than 80% of SSA populations and pathways to reduce missed diagnoses and late referrals. More substantial
investment is needed in developing cancer registries and cancer diagnostics for core cancer tests.
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The IDF Diabetes Atlas report highlights the disproportionate prevalence of type 2 diabetes (T2D) among Indigenous Peoples globally. It emphasizes the social and health disparities resulting from colonization, loss of traditional practices, and systemic inequities. The report includes prevalence dat
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a across various Indigenous populations, identifying significant variability and often higher rates among Indigenous women compared to men. The report calls for culturally responsive and community-driven interventions to address diabetes prevention and management while advocating for better data collection and representation to support Indigenous communities worldwide.
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The Lancet Volume 390, Issue 10110p2397-2409November 25, 2017.
Human African trypanosomiasis (HAT), also called sleeping sickness, is a parasitic infection that almost invariably progresses to death, unless treatment is provided. HAT caused devastating epidemics during the 20th century. Thanks to
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sustained and coordinated efforts during the past 15 years the number of reported cases has fallen to a historic low. Fewer than 3,000 cases were reported in 2015, and the disease is targeted for elimination by the World Health Organization. Despite recent success, HAT still poses a heavy burden on the rural communities where this highly focal disease occurs, most notably in Central Africa. Since patients are also reported from non-endemic countries outside Africa, HAT should be considered in differential diagnosis for all travellers, tourists, migrants and expatriates who have visited or lived in endemic areas. In the absence of a vaccine, disease control relies on case detection and treatment, and vector control. Available drugs are sub-optimal, but ongoing clinical trials give hope for safer and simpler treatments.
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JOIN European First Aid Guidelines
recommended
In the event of an accident or medical emergency, First Aid saves lives. Keeping the patient alive and safe until the arrival of expert professional help is a vital part of the chain of care which leads to recovery. The principle of First Aid must be simple skills, clearly taught and capable of bein
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g performed in a stressful situation by those with no medical training. This manual is intended to offer a basic level of First Aid for members of the general public.
The contents of this manual are offered as a first edition of European First Aid Guidelines for general use. As such they are compatible with current practise, with other specialist guidelines (for example regarding the management of burns) and with the evidence base where one exists. These guidelines will be updated on a regular basis by the JOIN Clinical Working Group.
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Since the Alma Ata Declaration in 1978, community health volunteers (CHVs) have been at the forefront, providing health services, especially to underserved communities, in low-income countries. However, consolidation of CHVs position within formal health systems has proved to be complex and continue
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s to challenge countries, as they devise strategies to strengthen primary healthcare. Malawi’s community health strategy, launched in 2017, is a novel attempt to harmonise the multiple health
service structures at the community level and strengthen service delivery through a team-based approach. The core community health team (CHT) consists of health surveillance assistants (HSAs), clinicians, environmental health officers and CHVs. This paper reviews Malawi’s strategy, with particular focus on the interface between HSAs, volunteers in community-based programmes and
the community health team. Our analysis identified key challenges that may impede the strategy’s implementation:
(1) inadequate training, imbalance of skill sets within CHTs and unclear job descriptions for CHVs; (2) proposed community-level interventions require expansion of pre-existing roles for most CHT members; and (3) district authorities may face challenges meeting financial obligations and filling community-level positions. For effective implementation, attention and further deliberation is needed on the appropriate forms of CHV support, CHT composition with possibilities of co-opting trained CHVs
from existing volunteer programmes into CHTs, review of CHT competencies and workload, strengthening coordination and communication across all community actors, and financing mechanisms. Policy support through the development of an addendum to the strategy, outlining opportunities for task-shifting between CHT members, CHVs’ expected duties and interactions with paid CHT personnel is recommended.
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Infection 2023 Oct;51(5):1399-1406. doi: 10.1007/s15010-023-01999-9. Epub 2023 Feb 20.
The results indicate a significantly higher rate of infections with S. mansoni in street children compared with orphans. This might be explained by the lack of access to adequate sanitation
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for street children as well as regular contact with the water of Lake Victoria. However, we did not find similar results concerning infection rates with protozoa. The study results show overall inadequate living conditions in this study population, which could be addressed by public health interventions.
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This publication provides an overview of evidence and guidance on the growing challenge of workplace heat stress in the context of climate change. It highlights the health and productivity risks faced by billions of workers, especially in manual labor sectors. The report details the physiological, s
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ocioeconomic, and mental health impacts of heat stress and outlines evidence-based strategies for prevention and mitigation. It emphasizes the need for occupational heat action programmes, stakeholder collaboration, and tailored interventions to protect vulnerable workers, reduce productivity losses, and support sustainable development in a warming world.
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